This therapy does seem to help some people, but most of the studies that have been done didn’t follow the most rigorous scientific standards for experiments.

Chuck Fanning gets a treatment on a spinal decompression table at the Wooten Clinic in Germantown. According to clinic director David Wooten (left), the treatment uses computer-controlled force to slowly decompress the spine and relieve pressure.

Photos by Matthew Craig/The Commercial Appeal

Gary Byars undergoes a spinal decompression treatment at the Wooten Clinic. Byars said that despite the fact he must pick up part of the cost of treatments, he's willing if it makes him feel better.

On a recent morning, Gary Byars lay on a table with his eyes closed as a machine slowly separated some bones in his neck.

Persistent pain and limited motion had brought Byars to the Germantown clinic of chiropractor David M. Wootton for spinal decompression therapy, a treatment that involves pulling and releasing the vertebrae.

Television infomercials and a sophisticated Web site help bring about 700 patients per year for spinal decompression therapy at Wootton's clinic. And he's not the only provider offering the treatment in the area.

The treatment seems to help some patients, but there are drawbacks.

It can cost thousands of dollars, and many insurers don't pay for it.

And it's still unproven, according to a 2006 article in the journal Pain Practice. Many studies of the technology showed no benefits for patients with lower back pain, and some that did show benefits didn't follow the highest scientific standards, the journal said.

Last year, Oregon's attorney general settled with proponents of the therapy, saying that advertisements airing in the state were based on "junk science."

Wootton said the therapy can help people who suffer from a variety of back ailments, including spinal disk problems.

"We're trying to create an awareness out there that there is one other option, a very effective option at resolving these disks prior to having back surgery," Wootton said.

The controversy illustrates larger issues surrounding back pain, which is very common and often hard to treat.

There are big questions about the effectiveness of a common back surgery technique, so many doctors let patients try nontraditional methods, even if the science behind them isn't very solid.

"I think it's all up to the person. If they feel like it's helpful to them, I'm not going to tell them to stop," said Heidi Prather, a spine physician and professor at Washington University Medical School in St. Louis.

But Prather said she doesn't use spinal decompression and is concerned that it's a passive treatment that might not correct underlying problems caused by the way the patient is moving.

Nationally, the treatment appears to be catching on. Some doctors apply it, but the primary users are chiropractors, who practice a healing art based on the concept that health and disease are related to the spine and nervous system.

A major supplier of spinal decompression equipment, Axiom Worldwide of Tampa, Fla., has 1,700 systems in use globally, said Gary Dixon, vice president of sales and marketing.

Roger Hartl, a neurosurgeon at Cornell University in Ithaca, N.Y., said he's not familiar with spinal decompression therapy but tries to exhaust nonsurgical options like drugs and physical therapy before cutting.

Even if doctors find a physical problem in the spine, fixing it won't necessarily help because doctors often don't know what's really causing back pain, he said.

Hartl is a believer in acupuncture, an Asian technique that involves inserting needles into pressure points.

Wootton said spinal decompression should be another nonsurgical option.

"And if we're able to affect a resolution in their condition or even improvement in their condition, that's just a wonderful thing for society in general," he said. "I can't tell you how disheartened I am when I have patients come in who've had plates and screws put in their back."

In spinal decompression, a machine gently tugs on problem vertebrae and then releases the tension, repeating the process several times in a 30-minute session, he said. The pulling doesn't hurt, he said.

The separation of the vertebrae creates negative pressure, he said.

In the case of a herniated disk, where the inside of the squishy cushion between spine bones has popped out like the filling of a jelly doughnut, the decompression sucks the tissue back into the disk and can reduce pressure on nearby nerves or the spinal cord, Wootton said.

The decompression also draws in fluid and nutrients that can regenerate disk tissue, he said.

He pointed to a Pain Practice article this year that found that spinal decompression reduces chronic lower back pain. But the authors of the study acknowledge shortcomings in the trial design and say more rigorous study is needed.

There's similar debate over studies of lumbar spinal fusion, a common surgery for extreme low back problems in which two or more vertebrae are bound together.

The federal Medicare health insurance program has considered ending coverage for the procedure due to lack of evidence that it's better than nonsurgical treatments.

In November 2006, a Medicare advisory panel called for more research. Medicare spokesman Don McLeod said the agency continues to pay for the surgery for now.

Patients often pay for spinal decompression therapy themselves. Patients at Wootton's clinic typically have 20 rounds of treatment, which cost $200 each, or a total of $4,000, followed by another type of chiropractic treatment, the chiropractor said.

Another group, Spinal Health Care Associates in Cordova, recently cut its per-treatment cost from $200 to $20, said Rock Wooster, a chiropractor there.

Patients like Byars, 52, of Cordova are willing to try them.

Lying on the table, Byars said it was only his sixth treatment, but he said it seemed to help his neck movement.

He said insurance covered part of the treatment, but he has to pay out of pocket too.

"I don't know how you put a value on feeling good and not being in pain," he said. "So for me it was just an investment in feeling good."

Spinal Science

Many of the studies of spinal decompression therapy didn't use the best scientific methods, and researchers say more study is needed.

Some studies were retrospective, meaning researchers reviewed patients' charts after they'd received therapy.

A better method is to separate patients at the beginning of the study into a group that receives the study treatment and a group that receives another treatment. Neither the patient nor the person measuring the progress knows what group they're in.